PHA-Exchange> Global AIDS epidemic continues to grow

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from Brian Pazvakavambwa <PazvakavambwaB at zw.afro.who.int> -----
    
Global AIDS epidemic continues to grow
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http://www.who.int/mediacentre/news/releases/2006/aids.epidemic.update/en/index
.html

New data also show HIV prevention programmes getting better results if focused 
on reaching people most at risk and adapted to changing national epidemics

21 NOVEMBER 2006 | GENEVA -- The global AIDS epidemic continues to grow and 
there is concerning evidence that some countries are seeing a resurgence in 
new HIV infection rates which were previously stable or declining. However, 
declines in infection rates are also being observed in some countries, as well 
as positive trends in young people's sexual behaviours.

Related links
:: UNAIDS/WHO AIDS Epidemic Update 2006 [pdf 2.21Mb] 
http://www.who.int/entity/hiv/mediacentre/2006_EpiUpdate_en.pdf

According to the latest figures published today in the UNAIDS/WHO 2006 AIDS 
Epidemic Update, an estimated 39.5 million people are living with HIV. There 
were 4.3 million new infections in 2006 with 2.8 million (65%) of these 
occurring in sub-Saharan Africa and important increases in Eastern Europe and 
Central Asia, where there are some indications that infection rates have risen 
by more than 50% since 2004. In 2006, 2.9 million people died of AIDS-related 
illnesses.

New data suggest that where HIV prevention programmes have not been sustained 
and/or adapted as epidemics have changed—infection rates in some countries are 
staying the same or going back up.

In North America and Western Europe, HIV prevention programmes have often not 
been sustained and the number of new infections has remained the same. 
Similarly in low- and middle-income countries, there are only a few examples 
of countries that have actually reduced new infections. And some countries 
that had showed earlier successes in reducing new infections, such as Uganda, 
have either slowed or are now experiencing increasing infection rates.

“This is worrying—as we know increased HIV prevention programmes in these 
countries have shown progress in the past—Uganda being a prime example. This 
means that countries are not moving at the same speed as their epidemics,” 
said UNAIDS Executive Director Dr Peter Piot. “We need to greatly intensify 
life-saving prevention efforts while we expand HIV treatment programmes.”

HIV prevention works but needs to be focused and sustained

New data from the report show that increased HIV prevention programmes that 
are focused and adapted to reach those most at risk of HIV infection are 
making inroads.

Positive trends in young people's sexual behaviours—increased use of condoms, 
delay of sexual debut, and fewer sexual partners—have taken place over the 
past decade in many countries with generalized epidemics. Declines in HIV 
prevalence among young people between 2000 and 2005 are evident in Botswana, 
Burundi, Côte d’Ivoire, Kenya, Malawi, Rwanda, Tanzania and Zimbabwe.

In other countries, even limited resources are showing high returns when 
investments are focused on the needs of people most likely to be exposed to 
HIV. In China, there are some examples of focused programmes for sex workers 
that have seen marked increases in condom use and decreases in rates of 
sexually transmitted infections, and programmes with injecting drug users are 
also showing progress in some regions. And in Portugal, HIV diagnoses among 
drug injectors were almost one third (31%) lower in 2005, compared with 2001, 
following the implementation of special prevention programmes focused on HIV 
and drug use.

Addressing the challenges: Know your epidemic

In many countries, HIV prevention programmes are not reaching the people most 
at risk of infection, such as young people, women and girls, men who have sex 
with men, sex workers and their clients, injecting drug users, and ethnic and 
cultural minorities. The report outlines how the issue of women and girls 
within the AIDS epidemic needs continued and increased attention. In sub-
Saharan Africa for example, women continue to be more likely than men to be 
infected with HIV and in most countries in the region they are also more 
likely to be the ones caring for people infected with HIV.

According to the report, there is increasing evidence of HIV outbreaks among 
men who have sex with men in Cambodia, China, India, Nepal, Pakistan, Thailand 
and Viet Nam as well as across Latin America but most national AIDS programmes 
fail to address the specific needs of these people. New data also show that 
HIV prevention programmes are failing to address the overlap between injecting 
drug use and sex work within the epidemics of Latin America, Eastern Europe 
and particularly Asia.

"It is imperative that we continue to increase investment in both HIV 
prevention and treatment services to reduce unnecessary deaths and illness 
from this disease,” said WHO Acting Director-General, Dr Anders Nordström. “In 
sub-Saharan Africa, the worst affected region, life expectancy at birth is now 
just 47 years, which is 30 years less than most high-income countries."

The AIDS Epidemic Update underlines how weak HIV surveillance in several 
regions including Latin America, the Caribbean, the Middle East, and North 
Africa often means that people at highest risk—men who have sex with men, sex 
workers, and injecting drug users—are not adequately reached through HIV 
prevention and treatment strategies because not enough is known about their 
particular situations and realities.

The report also highlights that levels of knowledge of safe sex and HIV remain 
low in many countries, as well as perception of personal risk. Even in 
countries where the epidemic has a very high impact, such as Swaziland and 
South Africa, a large proportion of the population do not believe they are at 
risk of becoming infected.

“Knowing your epidemic and understanding the drivers of the epidemic such as 
inequality between men and women and homophobia is absolutely fundamental to 
the long-term response to AIDS. Action must not only be increased 
dramatically, but must also be strategic, focused and sustainable to ensure 
that the money reaches those who need it most,” said Dr Piot.

The annual AIDS Epidemic Update reports on the latest developments in the 
global AIDS epidemic. With maps and regional estimates, the 2006 edition 
provides the most recent estimates on the epidemic’s scope and human toll and 
explores new trends in the epidemic’s evolution. The report is available at 
www.unaids.org

UNAIDS, the Joint United Nations Programme on HIV/AIDS, brings together the 
efforts and resources of ten UN system organizations to the global AIDS 
response. Cosponsors include UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, ILO, 
UNESCO, WHO and the World Bank. Based in Geneva, the UNAIDS Secretariat works 
on the ground in more than 75 countries worldwide.

As the directing and coordinating authority on international health work, the 
World Health Organization (WHO) takes the lead within the UN system in the 
global health sector response to HIV/AIDS. WHO provides technical, evidence-
based support to Member States to help strengthen health systems to provide a 
comprehensive and sustainable response to HIV/AIDS including treatment, care, 
support and prevention services through the health sector.


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